A. Anginal Pain
In conditions such as angina, where oxygen supply to the heart muscle is low, the frequency and severity of chest pain may be increased by cigarettes. Nicotine causes a slight increase in blood pressure and heart rate. Therefore, the heart muscle demands more oxygen. Thus, the combina¬tion of carbon monoxide and nicotine increases the bad effects. Patients with angina who are smokers develop chest pain at lower levels of exercise. See chapter entitled Angina. Other components of cigarette smoking include a glycoprotein that is highly allergenic and may cause shortness of breath, asthmatic attacks, or eye irritation. In addition, the glycoprotein is believed to cause damage to the lining of arteries and an increase in atherosclerosis.
B. Impotence
Smoking causes endothelial dysfunction and appears to cause a constriction of small penile arteries implicated as one of the many factors responsible for impotence in some individuals. Endothelial dysfunction is common to the pathophysiology of both erectile dysfunction and coronary artery disease events.